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Am J Perinatol 2021; 38(S 01): e299-e308
DOI: 10.1055/s-0040-1710033
Original Article

Near-Infrared Spectroscopy: A Tool for Diagnosing Necrotizing Enterocolitis at Onset of Symptoms in Preterm Neonates with Acute Gastrointestinal Symptoms?

Julia Le Bouhellec
1   Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Olivier Prodhomme
2   Department of Pediatric Radiology, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Thibault Mura
3   Department of Medical Information, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Aurélien Jacquot
1   Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Clémentine Combes
1   Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Lucie Gamon
3   Department of Medical Information, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Sabine Durand
1   Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Anne Filleron
4   Department of Pediatrics, Carémeau Hospital, Nîmes University Hospital Center, Nîmes, France
,
Gilles Cambonie 
1   Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
› Institutsangaben Funding All phases of this study were supported by Montpellier University Hospital Center (Grant: research contract 2012–2015).
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Erratum zu diesem Artikel:

Erratum: Near-Infrared Spectroscopy: A Tool for Diagnosing Necrotizing Enterocolitis at Onset of Symptoms in Preterm Neonates with Acute Gastrointestinal Symptoms?Am J Perinatol 2021; 38(S 01): e371-e371
DOI: 10.1055/s-0040-1712478

Abstract

Objective In premature neonates, bloody stools and/or abdominal distension with feeding intolerance may be inaugural signs of necrotizing enterocolitis (NEC). We assessed the ability of near-infrared spectroscopy (NIRS) to distinguish those neonates with NEC soon after the occurrence of these symptoms.

Study Design We prospectively collected NIRS measurements of abdominal and cerebral regional tissue oxygen saturation (r-SO2), with values masked by an opaque cover. Two physicians, blinded to the NIRS data, determined whether the gastrointestinal symptoms were related to NEC 10 days after symptom onset.

Results Forty-five neonates with mean (standard deviation [SD]) gestational, birth weight and postnatal ages of 31 (3.9) weeks, 1,486 (794) g, and 18 (14) days were enrolled over 30 months. Gastrointestinal symptoms were related to NEC in 23 patients and associated with other causes in 22. Analysis of the 48 hours of monitoring revealed comparable abdominal r-SO2 and splanchnic-cerebral oxygenation ratio (SCOR) in patients with and without NEC (r-SO2: 47.3 [20.4] vs. 50.4 [17.8], p = 0.59, SCOR: 0.64 [0.26] vs. 0.69 [0.24], p = 0.51). Results were unchanged after NIRS analysis in 6-hour periods, and restriction of the analysis to severe NEC (i.e., grade 2 and 3, 57% of the NEC cases).

Conclusion In this study, NIRS monitoring was unable to individualize NEC in premature infants with acute gastrointestinal symptoms.

Keywords

diagnostic techniques - near-infrared spectroscopy - necrotizing enterocolitis - premature neonate


Publikationsverlauf

Eingereicht: 16. Oktober 2019

Angenommen: 19. März 2020

Artikel online veröffentlicht:
23. April 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med 2011; 364 (03) 255-264
    CrossrefPubMedGoogle Scholar
  • 2 Thyoka M, de Coppi P, Eaton S. et al. Advanced necrotizing enterocolitis part 1: mortality. Eur J Pediatr Surg 2012; 22 (01) 8-12
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 3 Hintz SR, Kendrick DE, Stoll BJ. et al; NICHD Neonatal Research Network. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis. Pediatrics 2005; 115 (03) 696-703
    CrossrefPubMedGoogle Scholar
  • 4 Rees CM, Pierro A, Eaton S. Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis. Arch Dis Child Fetal Neonatal Ed 2007; 92 (03) F193-F198
    CrossrefPubMedGoogle Scholar
  • 5 Kirtsman M, Yoon EW, Ojah C, Cieslak Z, Lee SK, Shah PS. Nil-per-os days and necrotizing enterocolitis in extremely preterm infants. Am J Perinatol 2015; 32 (08) 785-794
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 6 Bailey SM, Hendricks-Muñoz KD, Wells JT, Mally P. Packed red blood cell transfusion increases regional cerebral and splanchnic tissue oxygen saturation in anemic symptomatic preterm infants. Am J Perinatol 2010; 27 (06) 445-453
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 7 McNeill S, Gatenby JC, McElroy S, Engelhardt B. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol 2011; 31 (01) 51-57
    CrossrefPubMedGoogle Scholar
  • 8 Sood BG, McLaughlin K, Cortez J. Near-infrared spectroscopy: applications in neonates. Semin Fetal Neonatal Med 2015; 20 (03) 164-172
    CrossrefPubMedGoogle Scholar
  • 9 Cortez J, Gupta M, Amaram A, Pizzino J, Sawhney M, Sood BG. Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates. J Matern Fetal Neonatal Med 2011; 24 (04) 574-582
    CrossrefPubMedGoogle Scholar
  • 10 Patel AK, Lazar DA, Burrin DG. et al. Abdominal near-infrared spectroscopy measurements are lower in preterm infants at risk for necrotizing enterocolitis. Pediatr Crit Care Med 2014; 15 (08) 735-741
    CrossrefPubMedGoogle Scholar
  • 11 Schat TE, van Zoonen AGJF, van der Laan ME. et al. Early cerebral and intestinal oxygenation in the risk assessment of necrotizing enterocolitis in preterm infants. Early Hum Dev 2019; 131: 75-80
    CrossrefPubMedGoogle Scholar
  • 12 Seager E, Longley C, Aladangady N, Banerjee J. Measurement of gut oxygenation in the neonatal population using near-infrared spectroscopy: a clinical tool?. Arch Dis Child Fetal Neonatal Ed 2020; 105 (01) 76-86
    CrossrefPubMedGoogle Scholar
  • 13 Fortune PM, Wagstaff M, Petros AJ. Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates. Intensive Care Med 2001; 27 (08) 1401-1407
    CrossrefPubMedGoogle Scholar
  • 14 Zabaneh RN, Cleary JP, Lieber CA. Mesentric oxygen saturations in premature twins with and without necrotizing enterocolitis. Pediatr Crit Care Med 2011; 12 (06) e404-e406
    CrossrefPubMedGoogle Scholar
  • 15 Debillon T, Zupan V, Ravault N, Magny JF, Dehan M. Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001; 85 (01) F36-F41
    CrossrefPubMedGoogle Scholar
  • 16 Pichler G, Höller N, Baik-Schneditz N. et al. Avoiding arterial hypotension in preterm neonates (AHIP)-A single center randomised controlled study investigating simultaneous near infrared spectroscopy measurements of cerebral and peripheral regional tissue oxygenation and dedicated interventions. Front Pediatr 2018; 6: 15
    CrossrefPubMedGoogle Scholar
  • 17 Mintzer JP, Parvez B, Chelala M, Alpan G, LaGamma EF. Quiescent variability of cerebral, renal, and splanchnic regional tissue oxygenation in very low birth weight neonates. J Neonatal Perinatal Med 2014; 7 (03) 199-206
    CrossrefPubMedGoogle Scholar
  • 18 Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 1986; 33 (01) 179-201
    CrossrefPubMedGoogle Scholar
  • 19 Rice ME, Harris GT. Comparing effect sizes in follow-up studies: ROC Area, Cohen's d, and r. Law Hum Behav 2005; 29 (05) 615-620
    CrossrefPubMedGoogle Scholar
  • 20 Stokes M, Chen F, Gunes F. , SAS Institute Inc. An Introduction to Bayesian Analysis with SAS/STAT Software. 2014 Accessed November 26, 2017 at: https://support.sas.com/resources/papers/proceedings14/SAS400-2014.pdf
    PubMedGoogle Scholar
  • 21 Terrin G, Passariello A, Canani RB, Manguso F, Paludetto R, Cascioli C. Minimal enteral feeding reduces the risk of sepsis in feed-intolerant very low birth weight newborns. Acta Paediatr 2009; 98 (01) 31-35
    CrossrefPubMedGoogle Scholar
  • 22 Maayan-Metzger A, Schushan-Eisen I, Kuint J. Management of isolated rectal bleeding in newborn infants: comparison of two time periods. Acta Paediatr 2010; 99 (02) 215-218
    PubMedGoogle Scholar
  • 23 Cobb BA, Carlo WA, Ambalavanan N. Gastric residuals and their relationship to necrotizing enterocolitis in very low birth weight infants. Pediatrics 2004; 113 (1 Pt 1): 50-53
    CrossrefPubMedGoogle Scholar
  • 24 Maayan-Metzger A, Ghanem N, Mazkereth R, Kuint J. Characteristics of neonates with isolated rectal bleeding. Arch Dis Child Fetal Neonatal Ed 2004; 89 (01) F68-F70
    CrossrefPubMedGoogle Scholar
  • 25 Oulmaati A, Hays S, Ben Said M, Maucort-Boulch D, Jordan I, Picaud JC. Risk factors of mild rectal bleeding in very low birth weight infants: a case control study. BMC Pediatr 2013; 13: 196
    CrossrefPubMedGoogle Scholar
  • 26 Sisk PM, Lambeth TM, Rojas MA. et al. Necrotizing enterocolitis and growth in preterm infants fed predominantly maternal milk, pasteurized donor milk, or preterm formula: a retrospective study. Am J Perinatol 2017; 34 (07) 676-683
    PubMedGoogle Scholar
  • 27 Stapleton GE, Eble BK, Dickerson HA, Andropoulos DB, Chang AC. Mesenteric oxygen desaturation in an infant with congenital heart disease and necrotizing enterocolitis. Tex Heart Inst J 2007; 34 (04) 442-444
    PubMedGoogle Scholar
  • 28 Cerbo RM, Maragliano R, Pozzi M. et al. Global perfusion assessment and tissue oxygen saturation in preterm infants: where are we?. Early Hum Dev 2013; 89 (Suppl. 01) S44-S46
    CrossrefPubMedGoogle Scholar
  • 29 Schat TE, Schurink M, van der Laan ME. et al. Near-infrared spectroscopy to predict the course of necrotizing enterocolitis. PLoS One 2016; 11 (05) e0154710
    CrossrefPubMedGoogle Scholar
  • 30 Schat TE, van der Laan ME, Schurink M. et al. Abdominal near-infrared spectroscopy in preterm infants: a comparison of splanchnic oxygen saturation measurements at two abdominal locations. Early Hum Dev 2014; 90 (07) 371-375
    CrossrefPubMedGoogle Scholar
  • 31 Al-Shargabi T, Reich D, Govindan RB. et al. Changes in autonomic tone in premature infants developing necrotizing enterocolitis. Am J Perinatol 2018; 35 (11) 1079-1086
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 32 Bin-Nun A, Booms C, Sabag N, Mevorach R, Algur N, Hammerman C. Rapid fecal calprotectin (FC) analysis: point of care testing for diagnosing early necrotizing enterocolitis. Am J Perinatol 2015; 32 (04) 337-342
    Artikel in Thieme ConnectPubMedGoogle Scholar